汉中地区儿童食源性沙门菌感染的病原学特征与分子流行情况研究
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1三二〇一医院,微生物免疫科,陕西 汉中 723000;2浙江大学医学院附属邵逸夫医院,肝病感染科, 浙江 杭州 310058

作者简介:

陈倩 女 主管检验师 研究方向为病原微生物血清学致病机制 E-mail: 401078642@qq.com

通讯作者:

张微 女 副主任检验师 研究方向为病原微生物耐药及毒力机制 E-mail: xiaoxiong435@126.com

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R155

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Analysis of etiological characteristics and molecular epidemiology of foodborne Salmonella in Children from the Hanzhong Region
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1Department of Microbiology, 3201 Hospital, Shaanxi Hanzhong 723000, China;2Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang Hangzhou 310058, China

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    摘要:

    目的 了解汉中地区儿童食源性疾病中沙门菌的感染及流行情况。方法 收集2018—2023年陕西省汉中某哨点医院因食源性疾病就诊的儿童临床样本,采用增菌培养方法和质谱鉴定技术对沙门菌进行检测,并对阳性菌株进行血清型分型、药敏试验及全基因组测序。结果 儿童送检样本505例,其中122例检出沙门菌,阳性率为24.16%。不同年龄组儿童沙门菌感染率存在差异,随着年龄增长,阳性率呈现下降趋势,患儿可疑暴露食品主要分布于水果类及其制品中,占比45.90%。鼠伤寒沙门菌检出率最高,肠炎沙门菌次之,血清型与序列型(ST)之间呈现高度一致性。药敏试验结果显示,沙门菌对氨苄西林的耐药率最高(81.36%),对头孢菌素类耐药率低,其中头孢噻肟为11.86%,头孢他啶为3.39%,头孢吡肟为5.08%,鼠伤寒沙门菌(ST34和ST19)呈广泛耐药,肠炎沙门菌(ST11)耐药谱窄,主要对氨苄西林耐药(94.12%)。β-内酰胺类blaTEM-1B基因携带率高,为69.49%,产超广谱β-内酰胺酶基因(blaCTX-M型)携带率5.08%,全基因组数据揭示鼠伤寒沙门菌ST34与ST19形成主导进化分支,部分菌株遗传距离邻近,仅存在0~9个单核苷酸多态性差异。结论 汉中地区儿童沙门菌感染呈下降趋势,但0~3岁婴幼儿仍是高危人群,水果类制品为关键暴露媒介。病原以鼠伤寒及肠炎沙门菌为主,且存在克隆传播可能,建议加强食品链中沙门菌监测与做好婴幼儿感染防护。

    Abstract:

    Objective To characterize the prevalence and molecular epidemiology of foodborne Salmonella among children in Hanzhong region.Methods From January 2018 to December 2023, clinical samples were collected from children diagnosed with foodborne diseases at a sentinel hospital in Hanzhong. Salmonella was detected using enrichment culture, followed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Positive isolates were further characterized by serotyping, antimicrobial susceptibility testing and whole-genome sequencing.Results A total of 505 clinical samples from children were tested, of which 122 (24.16%)were positive for Salmonella . The prevalence varied across age groups, showing a declining trend with increasing age. Fruits and their products were the most common suspected exposure sources, accounting for 45.90% of all cases. Salmonella Typhimurium was the most prevalent serotype, followed by Salmonella Enteritidis. A consistent linkage was observed between serotypes and their corresponding sequence types (STs). Antimicrobial susceptibility testing showed that Salmonella isolates had the highest resistance rate against ampicillin (81.36%), and relatively low resistance rate to cephalosporins, including 11.86% to cefotaxime, 3.39% to ceftazidime, and 5.08% to cefepime. Most of Salmonella typhimurium (ST34/ST19) was multidrug resistant, while Salmonella enteritidis (ST11) exhibited a limited resistance profile, with resistance mainly against ampicillin (94.12%). The β-lactamase gene blaTEM-1B gene was harbored at a high frequency (69.49%), while the extended-spectrum β-lactamase gene blaCTX-M was found in 5.08% of the isolates. Whole-genome analysis revealed that Salmonella Typhimurium ST34 and ST19 form dominant clades, from which single-nucleotide polymorphisms (SNPs) of 0-9 between strains was found, reflecting their close genetic relatedness.Conclusion The prevalence of Salmonella infection among children in Hanzhong decreased from 2018 to 2023, however, infants aged 0-3 years remain a high-risk group, with fruit and fruit-based products as the key exposure vehicle. Salmonella typhimurium and Salmonella enteritidis are the dominant serotypes, and may undergo clonal transmission. Therefore, enhanced monitoring of the food chain and improved safeguards for infants and young children are recommended.

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陈倩,侯轩,辜依海,翁蕊,王辉,牟建,张微.汉中地区儿童食源性沙门菌感染的病原学特征与分子流行情况研究[J].中国食品卫生杂志,2026,38(2):104-112.

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  • 收稿日期:2025-09-28
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  • 在线发布日期: 2026-06-01
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